This study aims to examine the national trends and disparities in mortality caused by liver failure among adult patients diagnosed with mental and behavioral disorders (MBDs) that are attributable to tobacco use in the United States using the Centers for Disease Control and Prevention (CDC) Wide-ranging online data for epidemiologic research mortality data. Understanding these trends is essential to identifying high-risk populations and informing targeted screening and early intervention strategies. The findings can guide integrated smoking cessation and liver disease management efforts to reduce preventable mortality in vulnerable groups. This descriptive study utilized CDC WONDER data for adults aged 25 years and older. Mortality cases were identified using the International Classification of Diseases, tenth revision codes K72 (Liver failure) and F17 (MBD due to tobacco use). Age-adjusted mortality rates (AAMRs) per 100,000 were computed and stratified by gender, race/ethnicity, census region, Urban-Rural status, and state. Joinpoint regression was applied to estimate annual percent changes with 95% confidence intervals, and statistical significance was defined as P < .05. A total of 46,227 deaths were analyzed, with most occurring in medical facilities (61.7%), followed by homes and nursing facilities. The overall AAMR rose from 0.074 in 1999 to 0.94 in 2020 and then slightly declined to 0.78 by 2023. Both females and males showed similar upward trends, with males having higher AAMRs. Non-Hispanic Whites experienced the largest long-term increase, while Hispanic and Black populations showed recent declines. Mortality increased more sharply in rural areas as compared to urban areas, and regionally, the Midwest and South had sharp rises. State-level rates were highest in North Dakota, Wyoming, and South Dakota and lowest in California, Virginia, and Massachusetts, highlighting significant geographic disparities in liver failure mortality among adults with MBDs due to tobacco use. Deaths due to liver failure in adults with MBDs due to tobacco use in the United States increased substantially in the last 20 years, with significant demographic and regional inequalities. These results indicate the necessity of targeted prevention, smoking cessation programs, and equitable healthcare policies in order to decrease the mortality rate.
Shahab et al. (2026) studied this question.